Brain stimulation for Alzheimer's disease patients shows promise

The Age, News 14/03/2017, picture by Justin McManus. Jo Duff who is participating in a trail to use magnetic brain stimulation to treat her Alzeimers. Photo: Justin McManus

Jo Duff had only left home a few minutes earlier. She was driving in familiar territory but suddenly she had no idea where she was. The houses looked strange. The local hotel was foreign. Unable to recognise any landmarks, she felt completely lost.

"It was quite unnerving," she said. "My mind just went blank, I didn't know where I was."

She phoned her husband, Bill, who was playing golf. He asked if she was near North Road, the closest main road to their house. But she wasn't sure.

"That made me very worried because she's driven down there a hundred times," he said.

Within a few weeks, the scenario repeated itself. It was enough to prompt Bill to mention it to his neurologist, who thought it was worth investigating further.

After a series of scans and tests, Jo was diagnosed with mild to moderate Alzheimer's disease. But two years on, she hasn't experienced the deteriorating mental capacity associated with the condition.

Instead the 78-year-old is able to remember things she couldn't previously. The fogginess that had muddled her head, blocking names and dates from being retrieved, had lifted.

Jo puts it down to the transcranial magnetic stimulation, or TMS, she received as part of a first of its kind trial to test the effect brain stimulation had on Alzheimer's disease.

Over six weeks, she received a strong kind of TMS called "theta burst stimulation". The treatment can target four sections of the brain in 12 minutes, compared to standard TMS which targets one section for 20 to 30 minutes.

The high-frequency bursts to the left and right frontal and the left and right parietal parts of the brain cause the neurons to fire, boosting activity and strengthening the brain's networks.

These network connections are known to weaken with Alzheimer's, compromising the brain's ability to remember things.

"Theta burst stimulation is thought to induce more changes in the brain," said Monash Alfred Psychiatry Research Centre neuroscientist Kate Hoy, who led the trial. "We are hoping that if we stimulate these regions, then we can get some of the connections to strengthen and the neurons will be talking to each other again in a way that hopefully will improve cognition, attention, memory and concentration."

Associate Professor Hoy is trialling the treatment on people with early stage Alzheimer's, in the hope early intervention will allow healthy brain function to be maintained or even restored.

She said that while the study was small and in its early stages the preliminary results were encouraging.

"There's very early indications that we may be able to press pause on Alzheimer's disease," she said. "But it is very early days."

Jo was one of 12 patients to participate in the first year of the four-year study. Jo was in the half that received real treatment, while six patients received a placebo treatment for comparison. Future stages of the study will expand the number of participants.

"Hopefully down the track this research will benefit people as well as Jo," Bill said. "As we know Alzheimer's is an awful disease and it's ever increasing, so if we can help other people by doing this treatment, it's fantastic."